Mums-to-be ignore smoking advice

Last updated at 07:28 12 August 2005

The majority of women fail to quit smoking during pregnancy - even when given specialist counselling to help them stop, researchers said today.

Women expecting a baby are encouraged to stop smoking because of the harmful effects of the chemicals on the foetus, which can lead to breathing disorders and other problems. But many still struggle to quit, especially women who are heavy smokers.

Now research, published in the British Medical Journal, has shown that, even when women are given extra counselling and advice to kick the habit, the majority still fail.

Researchers from the University of Glasgow looked at the impact of motivational interviewing by specially-trained midwives to help pregnant smokers to stop.

It is estimated that a third of pregnant women smoke, with present guidelines recommending they be offered intensive support to help them quit.

This includes motivational interviewing - one-to-one counselling designed to treat addictions. The researchers studied 762 pregnant women who were regular smokers when they became pregnant.

One-to-one advice

All of the women were given standard health promotion information, but 351 were also offered up to five motivational interviews at home with specially-trained midwives.

The researchers measured the women's levels of cotinine - a by-product of nicotine found in the blood and saliva - to check the results in women who said they were quitting or cutting down on cigarettes.

They found there were no significant differences in changes to smoking behaviour between the group given standard health information - the controls - and those given counselling as well.

In those offered counselling, 17 (4.8 per cent) stopped smoking, compared to 19 (4.6 per cent) in the control group. Fifteen (4.2 per cent) women in the counselling group cut down on the number of cigarettes they were smoking, compared to 26 (6.3 per cent) in the control group.

The researchers concluded: "A good standard of motivational interviewing provided by midwives did not help women who were smoking at maternity booking to stop smoking."

They said that behavioural interventions alone in heavily-addicted pregnant women were unlikely to be effective enough to provide good value for money.

Nicotine replacement therapy is often effective in helping smokers stop, but is not routinely recommended during pregnancy.

But the researchers said that midwives could provide close supervision of nicotine replacement in women who would not be able to stop otherwise, once its safety and effectiveness had been examined.